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Role of glutamine in alleviating mucositis in head and neck cancer patients

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Created On: 03/02/2025

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Key take away

Glutamine significantly reduces salivary TGF-β1 levels, improves radiation-induced oral mucositis severity scores, decreases opioid use, and minimizes body mass index decline in head and neck cancer patients.

Background

A double-blind, randomized controlled trial sought to determine the therapeutic potential of glutamine oral suspension in mitigating radiation-induced oral mucositis (RIOM) among head and neck cancer (HNC) patients. Specifically, it investigated its impact on salivary transforming growth factor beta 1 (TGF-β1) levels and RIOM severity—marking the first exploration of glutamine's influence on TGF-β1 in this context.

Method

Overall, 50 participants were randomly allocated to get either glutamine oral suspension (test group) or maltodextrin oral suspension (control group). RIOM severity was determined via the WHO Oral Toxicity Scale, Oral Mucositis Assessment Scale (OMAS), Pain Visual Analog Scale (Pain-VAS), opioid use incidence, body mass index, and salivary TGF-β1 levels.

Result

Among the 40 patients (test group n = 20; control group n = 20) who completed radiotherapy, multivariate analysis revealed that glutamine markedly reduced salivary TGF-β1 levels. It also illustrated marked improvements in RIOM severity scores across the WHO Oral Toxicity Scale, OMAS, and Pain-VAS, while minimizing opioid dependency and body mass index decline.

Conclusion

Glutamine appears to be a promising therapeutic intervention, modulating inflammation and accelerating wound healing by targeting salivary TGF-β1 reduction in RIOM. These findings underscore its potential to revolutionize RIOM care and boost nutritional support, thereby enhancing radiation therapy outcomes.